What is Sertoli cell-only syndrome?

-- L.

Sertoli cell-only syndrome is a condition in which the sperm-producing cells are no longer present in the testicle. When no sperm are seen on semen analysis, the first question I ask is whether this is due to a failure of sperm production, or to a blockage between the testicle and the penis. A blood test for FSH is performed first. If FSH is elevated, this indicates a failure of sperm production. That may be due to infection, injury, medication, radiation or genetics.

A testicular biopsy will answer the question of whether sperm are being produced. Unfortunately, a single biopsy may not settle the issue. Sertoli cell-only syndrome or an arrest in sperm development may been seen in one small section of the biopsy, while normal sperm can be retrieved from another. So if your diagnosis was made from a single biopsy, taking a sample from the other side may change the prognosis.

Even in cases where a high FSH would appear to indicate a failure of sperm production, occasionally some sperm can be harvested. At the time of biopsy, your physician should be prepared to process and cryopreserve any sperm that may be present, so that they can be used later for IVF and sperm injection (ICSI). As conditions resulting in abnormal sperm production may passed on to your male offspring, genetic testing is recommended.